Echocardiographic Assessment of Cardiac Structural and Functional Abnormalities in Patients With End-Stage Renal Disease Receiving Chronic Hemodialysis

• Published in: Circulation Journal Vol. 82; no. 2; pp. 586 - 595
• Main Authors: Matsuo, Hiroshi, Dohi, Kaoru, Machida, Hirofumi, Takeuchi, Hideyuki, Aoki, Toshikazu, Nishimura, Hiroyuki, Yasutomi, Masashi, Senga, Michiharu, Ichikawa, Takehiko, Kakuta, Kentaro, Mizutani, Yasuhide, Tanoue, Akiko, Isaka, Naoki, Oosugi, Kazuki, Koyabu, Sukenari, Sakurai, Masato, Fukui, Yoshihisa, Kakimoto, Hitoshi, Sugimoto, Tadafumi, Ohnishi, Takahiro, Murata, Tomohiro, Ishikawa, Eiji, Okamoto, Ryuji, Yamada, Tomomi, Ogura, Toru, Nishimura, Yuki, Tanigawa, Takashi, Nomura, Shinsuke, Nishikawa, Masakatsu, Ito, Masaaki
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 25.01.2018
• Subjects: Aged; Aortic valve sclerosis; Aortic Valve Stenosis; Calcinosis; Echocardiography; Echocardiography - methods; End-stage renal disease; Heart Defects, Congenital - diagnostic imaging; Hemodialysis; Humans; Kidney Failure, Chronic - complications; Left ventricle; Middle Aged; Mitral Valve - pathology; Parathyroid Hormone - blood; Prospective Studies; Renal Dialysis; Risk Factors; Ventricular Function, Left; End-stage renal disease; Echocardiography; Aortic valve sclerosis; Hemodialysis; Left ventricle
• ISSN: 1346-9843; 1347-4820; 1347-4820
• DOI: 10.1253/circj.CJ-17-0393

Background:The aim of this study was to assess the echocardiographic characteristics of chronic hemodialysis (HD) patients with end-stage renal disease (ESRD) in a multicenter prospective cohort study.Methods and Results:Three hundred and fifteen patients with ESRD (67.9±10.6 years, 47.6% male) on chronic HD for ≥1 year were examined on transthoracic echocardiography, including Doppler-derived aortic valve area (AVA) measurement. Only 11.5% and 3.4% of all patients had normal left ventricular (LV) geometry and normal LV filling pattern, respectively. The majority of patients had aortic and mitral valvular calcification, and approximately 50% of all 315 patients had aortic valve narrowing with AVA <2.0 cm2. Patients were divided into 3 groups according to AVA index tertile: group 1, highest tertile; group 2, middle tertile; and group 3, lowest tertile. Group 3 was older, had a greater cardiothoracic ratio on chest X-ray, higher plasma brain natriuretic peptide and total LV afterload, and lower stroke volume index than the other 2 groups. Age and intact parathyroid hormone (PTH) level were independently associated with low AVA index.Conclusions:Patients with ESRD on chronic HD have a high prevalence of cardiac structural and functional abnormalities including calcified aortic sclerosis. High age and PTH were associated with aortic valve narrowing in these patients.